Prostate-specific Antigen Test
In the context of advanced health assessment and diagnostic reasoning, the healthcare practitioner employs various assessment tools and diagnostic tests to narrow down the diagnosis. The selection and utilization of appropriate assessment tools and diagnostic tests are crucial for ensuring the validity and reliability of the practitioner’s reasoning. This article focuses on the prostate-specific antigen (PSA) test, its evaluation, and the discussion of its validity and reliability.
Health Interview
During the health interview, the practitioner aims to gather specific information related to potential areas that require screening or further assessment for maintaining the patient’s health. Although some of these areas may be uncomfortable for patients to discuss or assess, timely evaluation can help detect underlying diseases and prevent potential complications. The interview should include questions about the patient’s family history of prostate disease, urinary issues (such as hesitancy, dribbling, stream maintenance, and frequency), and the age at which men should undergo a PSA test (usually at fifty, unless there is a history of prostate cancer). NURS 6512 Week 3 Prostate-specific Antigen Test
Prostate-specific Antigen (PSA) Test
Prostate cancer is a common malignancy among aging males, and routine screening, including a PSA test, facilitates the early detection of cancer and enables appropriate follow-up. Elevated levels of PSA may also indicate an enlarged or inflamed prostate. The PSA test is a unique diagnostic and screening tool due to its specificity to prostate diseases. It is a simple blood test that can be performed at a laboratory or physician’s office. While PSA is primarily found in semen, small amounts circulate in the blood.
PSA Validity and Reliability
Although the PSA test is commonly used for screening prostate cancer, it is not necessarily specific to this disease. Elevated PSA levels have been observed in patients with benign prostatic hyperplasia (BPH), prostatitis, and following physical trauma to the prostate. Concerns have been raised regarding the validity of the PSA test due to its false-positive rate, overtreatment, and inferior accuracy. The United States Preventive Services Task Force (USPSTF) recommends against PSA-based screening for prostate cancer, as it often detects asymptomatic cases. While the PSA test can be valid and reliable for testing prostate disease, it may not be necessary for all asymptomatic males. The test has led to increased diagnoses and treatment of prostate cancer, even in cases that would not have caused symptoms or death. Furthermore, the PSA test cannot predict the stage of cancer or the rate of its progression.
NURS 6512 Week 3 Prostate-specific Antigen Test
Considering that prostate cancer is generally slow-growing, with only a small percentage being aggressive, healthcare practitioners must delicately address the PSA test with patients. Shared decision-making is essential, and high-risk patients (those with a family history or African American) should be screened. Other patients should consider their age, life expectancy, and the potential benefits and risks of further testing and treatment. Some individuals may prioritize avoiding complications from biopsies and subsequent treatment and choose to decline screening, while others, including high-risk patients, may prefer to detect and treat potential prostate cancer.
Conclusion
The PSA test, although unreliable as a screening tool for prostate cancer, can effectively detect prostate diseases and is not necessary for all aging males, particularly asymptomatic individuals. Prior to making a joint decision, healthcare practitioners should conduct a comprehensive interview that includes assessing family history. High-risk patients can choose to undergo or forego testing based on their family history and the careful consideration of the advantages and disadvantages of obtaining the knowledge. Given the slow-growing nature of most prostate cancers, individuals without symptoms can reasonably assume that no complications will arise before the end of their life. NURS 6512 Week 3 Prostate-specific Antigen Test
References
Khalid, A. N. (2015). Stepwise management of asthma. International Forum of Allergy & Rhinology, 5(S1). doi: 10.1002/alr.21606
National Heart Lung and Blood Institute. (2007). Expert panel report 3 (EPR3): Guidelines for the diagnosis and management of asthma. Retrieved from
http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm
Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier.
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